Endometriosis negatively affects QoL. A consensus must be reached as to which QoL instrument should be used to make studies comparable.

OBJECTIVETo analyze the costs of hysterectomies performed in Brazil due to benign conditions, and to assess its hospital admittance and mortality rates.METHODSA retrospective cohort was carried out from January 2010 to December 2014, analyzing all hysterectomies (n = 428,346) registered on the DATASUS database between January 2010 and December 2014. Data were collected through a structured questionnaire and analyzed using the SPSS 20.0 for Windows.RESULTSHospital admissions were 300,231 for total abdominal hysterectomies, 46,056 for vaginal hysterectomies, 29,959 for subtotal abdominal hysterectomies and 1,522 for laparoscopic hysterectomies. Mortality rates were 0.26%, 0.09%, 0.07% and 0.05% for subtotal, total abdominal, laparoscopic, and vaginal hysterectomies, respectively. Among the procedures studied, total abdominal hysterectomies had the most costs (R$217,802,574.77), followed by vaginal hysterectomies (R$24,173,490.00), subtotal abdominal hysterectomies (R$19.253.300,00) and laparoscopic hysterectomies (R$794,680.40).CONCLUSIONSTotal abdominal hysterectomies had the highest overall costs mainly because it was the most commonly performed technique. Mortality rates were greatest in subtotal abdominal hysterectomies; this, however, may be due to bias related to missing data in our database.

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Endometriosis can have several different presentations, including overt ascites and peritonitis; increased awareness can improve diagnostic accuracy and patient outcomes. We aim to provide a systematic review and report a case of endometriosis with this unusual clinical presentation. The PubMed/MEDLINE database was systematically reviewed until October 2016. Women with histologically-proven endometriosis presenting with clinically significant ascites and/or frozen abdomen and/or encapsulating peritonitis were included; those with potentially confounding conditions were excluded. Our search yielded 37 articles describing 42 women, all of reproductive age. Ascites was mostly hemorrhagic, recurrent and not predicted by cancer antigen 125 (CA-125) levels. In turn, dysmenorrhea, dyspareunia and infertility were not consistently reported. The treatment choices and outcomes were different across the studies, and are described in detail. Endometriosis should be a differential diagnosis of massive hemorrhagic ascites in women of reproductive age.

PFM function assessed by bidigital palpation in postmenopausal women was not sufficiently sensitive to differentiate between women with vs. women without PFM dysfunction and was not related with specific quality of life in women with urinary incontinence and pelvic organ prolapse, respectively. These data should be used to reinforce the widespread recommendation that PFM training is essencial in PFD treatment.

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Introduction: The knowledge of the relationship between Visceral Leishmaniosis and climatic aspects is already well established in the literature of other countries, but lack data of this relationship in Brazil. Objective: This study aimed to describe the seasonal distribution of hospitalizations for Visceral Leishmaniosis (VL) in a referral hospital for infectious diseases located in an endemic area of the semiarid in the Northeast of Brazil. Methods: The number of monthly hospitalizations between 2003 and 2012 was recorded retrospectively and was correlated with climate variables. Results: During this period 1,302 patients were hospitalized. We observed an inverse relationship with the monthly amount of precipitation (r = - 0.725; p = 0.008), the number of days per month with precipitation (r = - 0.683; p = 0.0144) and relative humidity (r = - 0.746; p = 0.005) when compared with the monthly number of hospitalizations due to VL. Inversely, there was a direct relationship with the maximum monthly mean temperature and the number of hospitalizations due to VL (r = 0.643; p = 0.024). Conclusions: The rainy season, characterized by more rainfall and higher humidity, was correlated with fewer hospitalizations for VL. Conversely, in months with higher temperatures the number of hospitalizations for VL was higher.

Introduction: complete androgen insensitivity syndrome is an X-linked mutation that causes a female phenotype, despite normal serum androgen levels. Patients have a 46,XY karyotype, female external genitalia, ectopic testes and absent Müllerian duct remnants. Case report: we present the case and surgical procedure of a 28-year-old patient who underwent laparoscopic gonadectomy in order to prevent gonadal malignancy. Conclusion: laparoscopy allows for the removal of gonads with the advantages of minimally invasive procedures.